AB0470 THE ASSOCIATIONS OF ANTI-DNA ANTIBODIES WITH DISEASE ACTIVITY INDICES AND PATIENT REPORT OUTCOME PARAMETERS OF SLE IN KYOTO LUPUS COHORT.
Authors: Y. Nakakubo, H. Tsuji, Y. Takase, T. Iwasaki, M. Shirakashi, H. Onizawa, R. Hiwa, K. Kitagori, S. Akizuki, R. Nakashima, A. Onishi, H. Yoshifuji, M. Tanaka, A. Morinobu
Journal: Annals of the Rheumatic Diseases (2022)

Background Since the goals of remission or low disease activity are becoming more realistic with advances in treatment for SLE, there is a need to examine the measurements for SLE especially in patients with low disease activity. It has been known that disease activities in SLE are correlated with anti-DNA antibodies (Abs). However, it was not clear which measurements of disease activities or patient reported outcomes correlate better with anti-DNA Abs. Objectives To examine the association between parameters for SLE and anti-DNA Abs measured with RIA in Kyoto Lupus Cohort, a SLE registry in Kyoto University Hospital from 2019 to 2021. Methods 1)Correlations between anti-DNA Abs with SLEDAI, M-SLEDAI (SLEDAI without anti-DNA Abs), VAS, LupusPRO, SF-36, and Systemic lupus erythematosus Symptom Checklist (SSC) were evaluated cross-sectionally (n = 310). 2)The alterations in SLE parameters and anti-DNA Abs between two visits were examined (n = 106). Further, the correlations within 3 months were examined in cases with flare-ups of SLE (the alteration in SLEDAI &gt; 0 and anti-DNA Abs≧0, n = 39). The associations of the alterations of anti-DNA Abs with each item of SLEDAI classified by organs were also examined. Results 1)31 percent of the cases in the entire registry was classified as remission or low disease activity (Table 1). SLEDAI (mean±SD) was higher in patients positive for anti-DNA Abs (7.94±5.20) than that in patients negative for anti-DNA Abs (4.56±4.65) (p &lt; 0.0001). Anti-DNA Abs were weakly correlated with SLEDAI (R = 0.24 [p &lt; 0.0001]), M-SLEDAI (R = 0.15 [p = 0.014]), and Physician-VAS (R = 0.19 [p = 0.0016]). On the other hand, there were no significant correlations between anti-DNA Abs and LupusPRO and SSC. Some dimensions in SF-36 had weak correlations with anti-DNA Abs, while no component summary scores had significant correlations with anti-DNA Abs. Table 1. Patients’ demographics and disease characteristics in the cohort (n = 310). Variable Results Age (years) 47.7 (39.4, 57.5) Female sex n = 284 (91.6%) Disease duration (years) 15.9 (9.4, 24.5) Anti-DNA Ab positivity† n = 106 (34.2%) Anti- DNA Ab titer (U/mL) 4 (0, 8) SLEDAI 4 (2, 8) SLEDAI&lt;=4 n = 162 (52.1%) SSC 31 (16.2, 52.5) Remission or LDA n = 95 (30.7%) Patient-VAS 38 (15, 52) Physician-VAS 13.3 (3.3, 23.3) SF-36 PCS 45.4 (36.6, 52.4) SF-36 MCS 48.2 (41.5, 53.6) SF-36 RCS 51.3 (42.6, 58.6) LupusPRO HQOL 70.2 (54.8, 86.5) LupusPRO NHQOL 41.7 (31.3, 51.0) Glucocorticoid (mg/day) 5 (4, 8) * Data are n (%) or median (Q1, Q3). † Anti-DNA Ab positivity at the time of the cross-sectional observation. 2)No significant correlations were observed between the alterations of SLEDAI and anti-DNA Abs (R = 0.00 [95% CI: -0.23 – 0.22, p = 0.95]) in the total of patients with various range of observation periods (Figure 1A). In contrast, a significant correlation was observed (R = 0.32, p = 0.04) within 3 months after the flare-ups of SLE (Figure 1B). No significant correlations were found between the alterations in VAS and anti-DNA Abs, or the alterations of SSC and anti-DNA Abs. They showed the following organ symptoms: renal involvement, 62.8%; musculoskeletal, 17.1%; neuropsychiatric, 11.4%; hematological, 5.7%; mucocutaneous, 11.4%; serositis, 2.9%, and fever, 2.9%. Figure 1. The associations between the alteration in anti-DNA Ab and SLEDAI Conclusion The associations between anti-DNA Abs with several parameters of SLE were examined. Anti-DNA Abs correlated with disease activities (SLEDAI) in SLE patients, especially when observed in the condition of flare-up. References [1]Ho A, et al. Arthritis Rheum. 2001;44:2342-9. Disclosure of Interests None declared